急性脑梗死患者颈内静脉血氧饱和度的临床研究  

Clinical study of jugular vein blood oxygen saturation in patients with acute cerebral infarction

作　　者：郑峥[1] 宿英英[1] 

机构地区：[1]首都医科大学宣武医院神经内科重症监护病房,北京100053

出　　处：《临床神经病学杂志》2006年第4期269-271,共3页Journal of Clinical Neurology

摘　　要：目的探讨急性脑梗死后脑氧代谢变化的规律及其对预后的预测价值。方法将35例急性脑梗死患者分成重症组[22例,格拉斯哥昏迷评分(GCS)≤8分]和非重症组(13例,GCS>8分),通过颈内静脉置管采血测定两组患者颈内静脉血氧饱和度(SjvO2),计算动脉颈内静脉氧含量差(AVDO2)和脑氧摄取率(OEF),并分别以SjvO270%、AVDO24ml/dl、OEF25%为界将患者分组,比较其预后。结果重症组SjvO2高于非重症组(P<0.01),OEF则低于非重症组(P<0.01)。SjvO2≥70%组预后不良的发生率高于SjvO2<70%组(P<0.01);OEF≤25%组高于OEF>25%组(P<0.01);而AVDO2≤4ml/dl组与AVDO2>4ml/dl组预后差别无显著性(P>0.05)。结论SjvO2和OEF可以客观地反映急性脑梗死后全脑氧代谢和脑血流状况,对预测其预后具有参考价值。Objective To investigate the changes in cerebral oxygen metabolism following acute cerebral infarction and their value for predicting prognosis. Methods Thirty five patients with acute cerebral infarction were enrolled and divided into two groups： severe group （22 cases, GCS≤8） and non-severe group （13 cases, GCS 〉 8 ）. Blood samples were obtained through jugular catheter and then jugular vein blood oxygen saturation （ SjvO2 ） was measured. Arteriovenous oxygen content difference （AVDO2 ） and oxygen extraction fraction （OEF） were calculated and compared simultaneously. The patients were grouped according to the critical value of SjvO2 （70%） , AVDO2 （4 ml/dl） and OEF （25%）. And the prognosis was compared between the two groups. Results SjvO2 of severe group was significantly higher than non-severe group （ P 〈0. 01 ）, while OEF was lower than non-severe group （ P 〈0. 01 ）. The unfavourable prognosis incidence of SjvO2/〉70% group was higher than SjvO2 〈 70% group （ P 〈 0. 01 ） , and the unfavourable prognosis incidence of OEF≤25% group was higher than OEF 〉 25% group （ P 〈0.01 ）. There was no remarkable difference of prognosis incidence between AVDO2≤4 ml/dl group and AVDO2 〉4 ml/dl group （P 〉 0. 05 ）. Conclusion SjvO2 and OEF may objectively reflect brain oxygen metabolism and cerebral blood flow after acute cerebral infarction. Furthermore, they are valuable indicators for predicting prognosis.

关 键 词：脑梗死 颈内静脉 血氧饱和度 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]